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Clinical Skills > Clinical Skills > Flashcards

Clinical Skills Flashcards

Just all your Clinical Skills from both BCHM 1 and 2. In preparation for your OSCES and just your knowledge of Clinical Stuff.

1
Q

Venepuncture

Describe the Uses of Tubes according to their colours (to contain blood)

Blue/Yellow or Red/ Green/Purple/Black/Grey

A

Blue- Filled up completely. Used for Cougulation Screen

Yellow/Red- Urea and electrolytes (kidney), CRP, Liver Function Tests, Amylase (Pancreas), Ca2+,P3-,Mg2+ levels, Thyroid Function Tests, Lipid Profile( E.g. Cholesterol)

Green- Troponin (Heart Disease)

Purple- Full Blood Count (FBC), Blood Film, CD4 count in HIV patients.

Black- For TB patients, ESR(Erythrocyte Sedimentation Rate)

Grey- Glucose and Lactate

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2
Q

Venepuncture

Describe the Steps to a Successful Venepuncture

A
  1. Find Suitable Vein
  2. Find and have tourniquet(taw-nuh-kay) nearby
  3. wash hands
  4. wear gloves
  5. clean venepuncture site and allow to dry
  6. perform (request patient to apply pressure for 5 minutes afterwards)
  7. dispose
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3
Q

Venepuncture

Which needle is ideal?

A

Black needle

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4
Q

Venepuncture

What do you do when you get a needlestick injury?

steps you need to take immediately

A

Rinse with copious(excess) water and allow to bleed freely

report to occupational health immediately to initiate HIV, Hep B and C, Syphillis prophylaxisis

Test patient for HIV, Hep B&C

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5
Q

venepuncture

what are possible pitfalls associated with taking of blood(Venepucture)?

A
  1. Always get consent from the patient
  2. Do not lie to patients and say it won’t be painful
  3. Do not take blood from the same arm as IV/TRANSFUSSION
  4. Syncore(temporary loss of consciousness from a drop in blood pressure)
  5. or worse yet, FAILURE, and it’s Okay. Try Again.
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6
Q

Urine Dipstix

How do you do a Urine Examination?

how do you examine urine?

A

1.Macroscopic(Colour, Clarity, Odour, Volume)

  1. Chemical(Dipstix)
  2. Microscopic(Culture and Sensitivity)
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7
Q

Urine Dipstix

Give Volume Ranges for Normal, Polyuria, Oliguria, Anuria and, Nocturia.

Give ranges and what they might be characteristic of.

A

Normal(600-1550ml)
Polyuria(>2000ml, in diabetes)
Oliguria(<400ml, in Kidney Dysfunction)
Anuria(<200ml, complete cessation of urine production)
Nocturia(excretion of urine by an adult of less than 500ml with a specific gravity of less than 1.08 at night)- characteristic of Chronic Glomerulonnephritis.

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8
Q

Urine Examination

Describe Urine Exam according to apprearance/colour.

A

Colourless- Lots of Water
Milky/Cloudy/Opaque-Urinary Tract Infections
Orange/Dark- Medication(chemotherapy drugs)/ Dehydration/ Hepatic or biliary conditions

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9
Q

Urine Specific Gravity

Give normal pH Urine value and describe what Acidic and Alkaline urin may indicate.

So say what Acidic and Alkaline Urine are indicative of

Urine pH

A

Normal= 4.6 to 8.5
Acidic= UTI(E.coli), Sysyemic acidosis, Ketosis, acidification therapy
Alkaline Urine= strict vegetation, systemic alkalosis

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10
Q

Urine Examination

What does haematuria indicate?

A

In young males it indicates of Kidney Stones!

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11
Q

What can bilirubin indicate when found in Urine?

biliribin is normally absent in Urine!

A

Liver diseases

Obstructive Jaundice (Obstruction to Bile Flow)

{NB} Even trace amounts of bilirubin are important

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12
Q

Urine Examination

What does a positive nitrite test in urine indicate?

A

Positive Nitrite Test indicates that bacteria may be present in significant numbers in Urine.

Conversion on nitrate to nitrite.

nitrites levels depend in the conversion of dietery nitrate by GNB

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13
Q

General Examination

What are the three parts of General Examination?

A
  1. General Inspection (appearance)[gait, habitus, face, hands and body]
  2. Vital Signs( HR, RR, BP, Temp, Pulse Oximetry)
  3. General Examination (JACCOLD)
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14
Q

General Examination

What do you look for under General Appearance when you do general examination?

A

Is the patient well or ill?
What is the patients mental state(alert, confused, somnolent, comatose)
Is the patient in respiratory distress?
Gait?
Dysmorphic Features

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15
Q

General Examination

Discuss types of GAIT

A

Normal
Spatic Gait: A stiff foot-dragging walking( UMN i.e. stroke)
Propulsive Gait : A stooped, stiff posture with the head and neck bend forward)
Steppage Gait: Foot drop where the foot hangs with the toes pointing down.
Waddling Gait: Duck-Like gait
Ataxic Gait: Alcohol intoxicated person
Antalgic Gait: Secondary to pain, Limping.

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16
Q

General Examination

What are vital signs?

A
  1. Heart Rate
  2. Respiratory rate
  3. temperature
  4. blood pressure
  5. oxygen saturation
17
Q

General Examination

What does JACCOLD stand for?

A

J- Jaundice
A- Anemia
C-Cyanosis
C-Clubbing
O-Oedema
L-Lymphadenopathy
D- Dehydration

18
Q

General Examination

How do you see Jaundice?

A

Yellowish discolouration of a patient’s skin and sclerae(EYE) as a result of hyperbilirubin

19
Q

How do you see Anemia?

A

Check for mucous membranes( skin under the eye)
If it’s pale, the patient has anemia

You can also look at the frenulum

20
Q

How do you see CYANOSIS?

A

Caused by deoxygenated Haemoglobin. Becomes Obvious when Oxygen Saturation falls below 90%.

21
Q

Describe the two types of cyanosis

A

Central- sign of severe hypoxaemia(caused by 1. Hypoventilation(CNS) 2. Respiratory System(Pneumonia and COPD) 3. Cardia Disorders 4. Blood(Methemoglobinemia) 5. Others (high altitue and hypothermia)

Peripheral- Occurs when blood to a particular area of the body is reduced( caused by arterial obstruction and Venous obstruction)

22
Q

general exam

What is clubbing?

A

def| increase in the soft tissue of the distal part of the fingers or toes.

palpate fingers to check for clubbing and check for schamroth’s sign

23
Q

What are the causes of CLUBBING?

the synonym is also CLUBBING

A

C- Congenital Cyanotic Heart Disease
L- Lung abscess
U- Ulcerative Colitis
B-Bronchogenic Carcinoma
B-Biliary Cirrhosis
I-Infective Endocarditis and Idiopathic Pulmonary Fibrosis
N- Neoplasm of Lung Liver
G- Graves Disease

24
Q

What are the two types of oedema and their causes?

A

Pitting Oedema and Non-Pitting Oedema

Non-pitting Oedema- caused By Hypothyrodism and Lymphoedema

Pitting Oedema is caused by Heart Failure, Nephrotic Syndrme, Drugs, Severe Lung Disease(causing right sided heart failure)

25
Q

List areas where you find LYMPH NODEs and can palpate them when checking for Lymphodenopathy

A

[cervical LN]
Submental
Submandibular
Jugular chain(ant. SCM)
Supraclavicular
Posterior Triangle(post SCM)
Post Auricular
Pre- Auricular
Occipital
[Epitrochlear LN]
[Axillary LN]
[Inguinal LN]

26
Q

what are signs of dehydration?

A

Sunken Eyes
Low blood Pressure
Hapid Heartbeat and rapid breathing

27
Q

How do you Examine the Hands?

A

look for clubbing, colour of nails, capillary reful, skin torgor

28
Q

How do you examine the Mouth?

A

Look for mouth ulcers
Look for Candidiasis (tongue turns white)

29
Q

What observations should be made in a Pulse?

A
  1. Rate
  2. Rhythm
  3. Character and Volume
  4. Pulse Delays and Pulse Deficit
30
Q

Describe ranges for normal pulse, Bradycardia and Techycardia.

A

Normal - [60 to 100 bpm]

Bradycardia- [<60 bmp]

Techycardia- [>100 bmp]

31
Q

What is Pulse Deficit?

A

Occurs when the heart rate counted by listening yo the heart with a Sthethoscope is higher than Heart Rate Obtained when the Radial Pulse is counted at the wrist.

32
Q

Define radiofemoral delay and what it is indicative of?

A

Radiofemoral delay is a delay between the upstroke of the right radial pulse and femoral pulse.
It is indication of coarctation of the Aorta which is basically the narrowing of the aorta.

33
Q

What is a usual cause of Radial-Radial Delay?

A

Usually due to Large Arterial occlusion on One Side.

Clinical Skills (1 decks)

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